Re: Health Bulletin

The hormone, oxytocin, could play a role in treating psychiatric disorders such as autism and schizophrenia, a new study has revealed.

According to the study conducted by Dr David Cochran of University of Massachusetts Medical School and his colleagues, oxytocin is an important regulator of human social behaviors.

The study also revealed that the hormone can also be useful for treating certain mental health diagnoses, particularly those which involve impaired social functioning.

A growing body of evidence in animals and humans has revealed that oxytocin, probably most familiar for its role in initiating labor and breast milk flow in pregnant women, plays an important role in regulating social behaviors.

Based on these effects, researchers have suspected that oxytocin may be a common factor in certain psychiatric disorders. The reviewers analyze the evidence for oxytocin's involvement in specific disorders-including some early research on oxytocin as a potential treatment for these conditions.
"The evidence suggests a role of oxytocin in the pathophysiology of some psychiatric disorders, particularly those characterized by impairments in social functioning," Dr Cochran and coauthors wrote.

Though the preliminary nature of the currently available data precludes a clear understanding of the exact nature of the hormone's role, the study showed that proper clinical trials would be able to provide a better understanding of the extent and limitations of the clinical effects of externally delivered oxytocin.

Re: Health Bulletin

‘Disgustologist’ finds how revulsion drives our lives

Valerie Curtis is fascinated by faeces. And by vomit, pus, urine, maggots and putrid flesh. It is not the oozing, reeking substances themselves that play on her mind, but our response to them and what it can teach us.

The doctor of anthropology and expert on hygiene and behaviour says disgust governs our lives - dictating what we eat, wear, buy and even how we vote and who we desire.

In science, disgust has languished unstudied - it was once dubbed the "forgotten emotion of psychiatry" - while emotions like fear, love and anger took the limelight.

But Curtis, who refers to herself half-jokingly as a "disgustologist", is among a growing group of scientists seeking to change that by establishing the importance of the science of revulsion in everything from sex and society to survival.

"People are disgusted by things without even realizing it. It influences our lives in so many subtle ways, and it's really important that we understand how great that influence is," she said.

"I've been trying to understand disgust for 30 years, and what I've found is that people the world over are all disgusted by similar things: body products, food that has gone off, sexual fluids - which, with a few exceptions, we don't tend to share with other people - bad manners and immoral behaviour," she said. In a book to be published this month entitled "Don't Look, Don't Touch", Curtis argues that while revulsion at rape and disgust of dog poo seem at first glance to be very different things, they have common roots in what she calls a "parasite avoidance theory" of disgust, or PAT for short. It looks at disgust from an evolutionary perspective, arguing that our most repulsed ancestors were aided in the "survival of the fittest" race by their disgust instinct - avoiding disease, deformity and death.

"Disgust is an organ - like an eye or an ear. It has a purpose, it's there for a reason," she said. "With disgust, you start with microbes, go on to manners and then on to morality," she says. "Disgust is fascinating because it's a model emotion," she said. "It tells us a lot about how all the emotions work."

Re: Health Bulletin

A coffee a day helps check fatty lever disease: Study

A coffee a day can help in keeping non-alcoholic fatty liver disease (NAFLD). The study published in international journal Hepatology has concluded that caffeine helps in reducing the fat (lipid) content on the liver. The study was undertaken by Rohit Sinha, a PhD scholar from Sanjay Gandhi Post Graduate Institute of Medical Sciences, who is now a senior research fellow at Duke-NUS Graduate Medical School, Singapore. The team was led by Prof Paul Yen.

NAFLD (Non-alcoholic fatty liver disease is accumulation of fat on the liver that makes it hard. Statistics say that nearly 25%-30% of the urban population in India has a fatty liver while about 1/3rd of people with fatty liver develop inflammation. North Indians face this problem more than south Indians.

Professor Gaur Chaudhury, a Lucknow-based gastrophysician explained that initially NAFLD is a benign condition that does not affect liver functions.

However, when the fat stores in the body reach optimal level and the body continues to receive excess fat, then the stores start throwing out fatty acids into the liver. In the initial stage fat accumulates in the liver but may not affect liver.Experts warn against NAFLD because of its silent nature. Consequences of a fatty liver are not immediately visible. But, when it does, it can be really serious. The problem occurs mostly in middle-ages, but a poor lifestyle can set it off much earlier. And if left untreated for long, it can lead to the most extreme form of NAFLD and can cause cirrhosis of the liver. He added that nearly 70% people with NASH are obese It is an important marker for diabetes, other metabolic diseases

Metabolic disorders like diabetes, hypertension and obesity increase the risk of NAFLD. Weight gain, especially around the waist, is one of the main causes of fatty liver. Over-dependence on junk food and sedentary lifestyle make matters worse. While there is no medication to effectively cure fatty liver, the only panacea is a healthy lifestyle, as NAFLD is a reversible problem.

"Skipping meals is a crime against the liver. In this way, humans simply abuse their body. The reason: when eating time is pushed, people just gobble what comes their way. Fast foods come as a handy option. And erratic eating time also means an intake that could be higher than usual. Together these factors lead to fat accumulation on the liver," said Prof Abhijit Chandra, head of gastroenterology department, King George's medical university.

Doctors say most cases of fatty liver are diagnosed accidentally, but insist that people with poor lipid profile, diabetes, hypertension and obesity should opt for regular check-ups. A poor lipid profile result is indication enough to get a liver function test done, especially for those who are middle-aged. Diabetes also slows down liver functioning as it is not able to burn sugar. In another dangerous trend, NAFLD is now being found in children as well. Obesity in growing children is to be blamed for this, doctors said.

Experts say that initially, there are no significant symptoms. Some non-specific symptoms may include fatigue, malaise, lethargy, dull ache in the upper right abdomen. However in the advance stages, NAFLD may cause lack of appetite, nausea, weight loss, weakness, fatigue, yellowing of skin and eyes, and swelling in legs and feet

Re: Health Bulletin

A universal flu vaccine to protect against new strains of the bird and swine flu may be a step closer, thanks to new study led by an Indian-origin scientist.

Scientists used the 2009 flu pandemic to study why some people seem to resist severe illness.

Researchers at Imperial College London asked volunteers to donate blood samples just as the swine flu pandemic was getting underway and report any symptoms they experienced over the next two flu seasons.

They found that those who avoided severe illness had more CD8 T cells, a type of virus-killing immune cell, in their blood at the start of the pandemic.

They believe a vaccine that stimulates the body to produce more of these cells could be effective at preventing flu viruses, including new strains that cross into humans from birds and pigs, from causing serious disease.

"New strains of flu are continuously emerging, some of which are deadly, and so the Holy Grail is to create a universal vaccine that would be effective against all strains of flu," Professor Ajit Lalvani from the National Heart and Lung Institute at Imperial College London, said.

Today's flu vaccines make the immune system produce antibodies that recognise structures on the surface of the virus to prevent infection with the most prevalent circulating strains. But they are usually one step behind as they have to be changed each year as new viruses with different surface structures evolve.

Lalvani's team rapidly recruited 342 staff and students at Imperial to take part in their study in autumn 2009. The volunteers donated blood samples and were given nasal swabs.

They found that those who fell more severely ill with flu had fewer CD8 T cells in their blood, and those who caught flu but had no symptoms or only mild symptoms had more of these cells.

"The immune system produces these CD8 T cells in response to usual seasonal flu. Unlike antibodies, they target the core of the virus, which doesn't change, even in new pandemic strains. The 2009 pandemic provided a unique natural experiment to test whether T cells could recognise, and protect us against, new strains that we haven't encountered before and to which we lack antibodies," Lalvani said.

"Our findings suggest that by making the body produce more of this specific type of CD8 T cell, you can protect people against symptomatic illness. This provides the blueprint for developing a universal flu vaccine.

"We already know how to stimulate the immune system to make CD8 T cells by vaccination. Now that we know these T cells may protect, we can design a vaccine to prevent people getting symptoms and transmitting infection to others. This could curb seasonal flu annually and protect people against future pandemics," said Lalvani.

Re: Health Bulletin

Vegetarians need extra vitamin B12

The alarming increase in vitamin B12 deficiency among Indians and its health implications-notably anaemia and cognitive decline-has now become a subject of research.

The central government's department of biotechnology has called in experts and scientists working in the field of public health to create a road map for understanding the burden of the disease and pinpointing alternative sources of vitamin B12, which can cater to the large vegetarian population of the country.

Vitamin B12, also called cobalamin, is a water-soluble vitamin. It plays a key role in the normal functioning of the brain and nervous system and the formation of blood.

"In India, approximately 60-70% of the population is believed to be having low vitamin B12 levels, with nearly 80% of urban middle class having this problem. Vegetarians have a 4.4 times higher risk of low vitamin B12 concentrations," said Swati Bhardwaj, senior research officer (Nutrition), Diabetes Foundation of India.

According to the DBT, recent evidence indicates that deficiency of vitamin B12 has profound implications for human health, notably anaemia and cognitive decline, particularly in elderly.

"Deficiency of this micronutrient may have some role in development of neural tube defects, adiposity, coronary artery disease, and autism spectrum disorders," said a DBT official.

Dr Anoop Misra, chairman, Fortis C-Doc Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, said till five years ago diagnosis of vitamin B12 deficiency was not stressed upon. "There was little awareness about it and the tests were costlier. We used to prescribe multivitamins to patients. But now with increasing evidence of the complications that deficiency of this micronutrient can cause, we are getting patients tested for it and prescribing specific supplements," he said. Diabetics, he added, are at higher risk for deficiency of vitamin B12 because metamorfin-one of the drugs prescribed to such patients-has the tendency to reduce its absorption.

A recent study published in Journal of Clinical Biochemistry and Nutrition found that adequate folic acid and vitamin B12 intake could help reduce vascular disease risk. It was found that plasma homocysteine concentrations, responsible for plaque formation leading to blockage of arteries, have a significant, negative correlation with vitamin B12 levels in patients with cerebrovascular ( stroke) and peripheral vascular disease (deep vein thrombosis).

"Large scale corrective measures like food fortification or dietary supplementation with folate and B12 might benefit the Indian population and reduce the incidence and morbidity of vascular disease," Dr Seema Bhargava, lead author of the study, and senior consultant, department of biochemistry at Sir Ganga Ram Hospital, said.

Re: Health Bulletin

People with depression may benefit as much from acupuncture as they do from counseling, suggests a new study.

Researchers found one in three patients was no longer depressed after three months of acupuncture or counseling, compared to one in five who received neither treatment.

"For people who have depression, who have tried various medical options, who are still not getting the benefit they want, they should try acupuncture or counseling as options that are now known to be clinically effective," said Hugh MacPherson, the study's lead author from the University of York in the UK.

Previous studies looking at whether acupuncture helps ease depression have been inconclusive. Those studies were also small and didn't compare acupuncture to other treatment options.

"What's more important for the patient is does it work in practice and that is the question we were asking," MacPherson said.

For their study, he and his colleagues recruited 755 people with moderate or severe depression. The researchers split participants into three groups: 302 were randomly assigned to receive 12 weekly acupuncture sessions, another 302 received weekly counseling sessions and 151 received usual care only.

About 70 percent of people had taken antidepressants in the three months before the study and about half reported taking pain medications. People did not have to stop taking their medicine to participate in the study.

At the outset, participants had an average depression score of 16 on a scale from 0 to 27, with higher scores symbolizing more severe depression. A 16 is considered moderately severe depression.

After three months, people assigned to the acupuncture group had an average score of about 9 - on the higher end of the mild depression category. Scores fell to 11 among members of the counseling group and about 13 in the usual care group, both considered moderate depression.
Participants who received acupuncture or counseling saw larger improvements over three months than those who had neither treatment. Those benefits remained for an additional three months after the treatments stopped.

However, any differences between acupuncture and counseling could have been due to chance, the researchers reported Tuesday in PLOS Medicine.
They found doctors would need to treat seven people using acupuncture and 10 people with counseling for one person to no longer be depressed.
"What this says is if you don't get completely better, there are other options," Dr. Philip Muskin, a psychiatrist at Columbia University Medical Center in New York, told Reuters Health.

"One option would be to take a different medication, but by this study these would be valid options," said Muskin, who was not involved with the new research.

He cautioned, however, that counseling and acupuncture are not replacements for medication. The majority of study participants were still taking antidepressants at the end of the three months.

Muskin said the study also doesn't show what types of patients respond best to acupuncture or counseling.

"What I can't tell from this study is who's who. Not everybody got better," he said.
MacPherson said it's best to ask patients for their treatment preference.
"If you talk to people, they would almost always have a leaning one way or the other," he said.
Acupuncture is only covered by health insurance in the UK for chronic pain, MacPherson said. In the U.S., some plans also cover acupuncture for pain or nausea.
According to online information from the Mayo Clinic, the risks of acupuncture are low if people hire competent and certified practitioners. Complications can include soreness, organ injury and infections.

"Cleary acupuncture is a new option," MacPherson said. "This is the first evidence that acupuncture really helps."

Re: Health Bulletin

Weight loss tied to knee arthritis benefits

Intensive weight loss together with regular exercise did more to ease knee arthritis than exercise alone for overweight and obese adults in a new U.S. study.

Knee inflammation, pain and functioning all improved more among people who cut back on calories in addition to working out, researchers found.
The greatest benefits were seen among those who lost the most weight, and they tended to be the ones who combined diet and exercise.
"While both the exercise and the diet interventions separately were beneficial, the combination of the two was superior in virtually every outcome," Stephen Messier, who led the study at Wake Forest University in Winston-Salem, North Carolina, said.

Extra weight is known to raise the risk of knee osteoarthritis, which happens when cartilage around the joint breaks down, causing inflammation, pain and stiffness.

One review found that being overweight doubles a person's risk of knee osteoarthritis, and being obese quadruples it (see Reuters Health story of April 15, 2011 here: reut.rs/dQl0ZZ).

For the new study, Messier and his colleagues wanted to see what effect losing weight through a strict diet program would have on arthritis symptoms.

They randomly assigned 454 overweight and obese adults with mild or moderate knee arthritis to 18 months of diet counseling, exercise or both.
For participants on the diet, the goal was to lose at least 10 percent of their starting weight. People replaced some meals with shakes and attended regular weight monitoring and nutrition sessions.

The exercise program involved one hour of physical activity three times per week, including aerobic walking and strength training.

By the end of the study, people assigned to both diet and exercise had lost an average of 23 pounds. That compared to almost 20 pounds in the diet-only group and four pounds among those who only exercised.
Compared to people in the exercise-only group, those who combined diet and exercise had less knee inflammation and pain and better functioning at 18 months.

For example, pain scores measured on a scale of 0 to 20, with higher scores indicating more pain, fell by 3.1 points in the diet plus exercise group and by 1.4 points in the exercise-alone group and about the same in the diet-alone group.
Likewise, on a 0-to-68 scale measuring knee function, people in the combined diet and exercise group improved by an average of 10.5 points, versus 4.7 points among those who only exercised.

People in the diet-alone and the diet plus exercise groups had about the same levels of knee inflammation - both lower than in the exercise-alone group.

"No one expects diet and exercise to have a huge impact" on osteoarthritis, Dr. Amanda Nelson, from the University of North Carolina at Chapel Hill's Thurston Arthritis Research Center, said.
"The fact that most of the improvements were modest is what we would expect to see."
Regardless of their group, participants who lost 10 percent of their body weight or more saw greater improvements in inflammation and other arthritis measures than those who dropped less weight, the researchers write in the Journal of the American Medical Association.

Messier told Reuters Health that exercise seems to have benefits for osteoarthritis independent of weight loss, so it should remain part of standard care.

Although not all patients may be able to find the same support provided in the study, many communities have YMCAs and other places people can go to get help with weight-loss and exercise goals, he noted.

Some people, Messier said, "just need help. If you have someone who is sedentary for most of their life … to just ask them, ‘Well, I think you need to lose a few pounds and exercise' and then walk out the door, it's not enough."

Nelson, who wasn't involved in the new research, told Reuters Health that people should also turn to family members and community groups for support, if possible.

Although a 10-percent weight loss continues to be the goal for overweight people with arthritis, even two pounds is better than nothing, she said.
"Patients should be encouraged that any weight loss is likely to be beneficial, and the more they can do the better," Nelson said.

Re: Health Bulletin

Eating walnuts daily can ward off diabetes and heart disease in at-risk individuals, a new study has found.

Researchers from the Yale-Griffin Prevention Research Center in Connecticut found that daily intake of 56 g of walnuts improves endothelial function in overweight adults with visceral adiposity.

The study included a sample of 46 adults aged 30-75.

Participants had a Body Mass Index larger than 25, and a waist circumference exceeding 40 inches for men and 35 inches for women.

They were also required to be non-smokers, and all exhibited one or more additional risk factors for metabolic syndrome, a precursor of diabetes and cardiovascular disease.

The group was randomly assigned to two 8-week sequences of either a walnut-enriched ad libitum diet or an ad libitum diet without walnuts.

Those chosen for the walnut diet were instructed to consume 56 g of shelled, unroasted English walnuts per day as a snack or with a meal.

"We know that improving diets tends to be hard, but adding a single food is easy," explained Dr David Katz, Director of the Yale-Griffin Prevention Research Center and lead author of the research team.

"Our theory is that if a highly nutritious, satiating food like walnuts is added to the diet, there are dual benefits: the benefits of that nutrient rich addition and removal of the less nutritious foods," Katz said.

The research found that daily intake of 56 g of walnuts improves endothelial function in overweight adults with visceral adiposity.

"The primary outcome measure was the change in flow-mediated vasodilatation (FMD) of the brachial artery," researchers said.

"FMD improved significantly from baseline when subjects consumed a walnut-enriched diet as compared with the control diet. Beneficial trends in systolic blood pressure reduction were seen, and maintenance of the baseline anthropometric values was also observed. Other measures were unaltered," they said.

The study is published in the Journal of the American College of Nutrition.